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Development of a consensus-base list of criteria for prescribing medication in a pediatric population
A Guérin1, J F Bussières2,3, R Boulkedid4,5
1Pharmacy Practice Research Unit, Pharmacy Department, Sainte-Justine University Health Center, 3175, chemin de la Côte Sainte-Catherine, Montreal, Quebec, H3T 1C5, Canada. aurelieguerin01@gmail.com.
Insights
This study developed a consensus-based tool to assess pediatric medication safety. The CIRCUS tool helps evaluate and improve best practices in the pediatric drug-use process, enhancing patient safety.
Area of Science:
- Pediatric Pharmacology
- Patient Safety
- Health Informatics
Background:
- Medication use in children carries significant risks of adverse events.
- The pediatric population is particularly vulnerable to medication-related harm.
- Optimizing the medication-use process is crucial for pediatric patient safety.
Purpose of the Study:
- To develop a consensus-based list of criteria for the pediatric medication-use process safety.
- To create the CIRCUS tool (CIRcuit-of-Child-drug-USe) for self-assessment of safety practices.
- To establish a standardized method for evaluating pediatric drug safety.
Main Methods:
- A multicenter approach involving experts from eight university hospitals.
- A comprehensive literature search (1998-2013) identified 26 safety practice domains.
- A two-round Delphi survey with 24 French-speaking multidisciplinary panelists (doctors, pharmacists, nurses) to rate 48 compliance criteria.
Main Results:
- A 92% participation rate was achieved, with 22 professionals completing the survey.
- Consensus was reached on 38 out of 48 (79%) safety practice compliance criteria.
- The consensus criteria were organized into 23 distinct domains.
Conclusions:
- A self-assessment tool, the CIRCUS tool, was developed for pediatric drug-use safety practices.
- The CIRCUS tool utilizes a Delphi method for consensus-based criterion development.
- This tool can be used to record and compare the prevalence of best safety practices in pediatric medication management.
Background:
Although many people are involved in the optimal use of a medication within this process, the use of medications carries risks of adverse events, which are greater in the pediatric population because of many factors.
Objective:
In this context, our aim was to develop a consensus-based list of criteria for the safety of the pediatric medication-use process or circuit (referred to from now on as the CIRCUS tool: CIRcuit-of-Child-drug-USe).
Setting:
Multicenter with a trio of experts from eight university hospitals.
Methods:
A literature search (1998-2013) was conducted in order to identify the different safety practice domains for the pediatric medication use process. Twenty-six safety practice domains were identified and 48 compliance criteria were formulated. In order to reach a consensus on the most relevant compliance criteria for safety practices, an international 24 French-speaking multidisciplinary panelists (8 doctors, 8 pharmacists and 8 nurses) selected to represent a broad range of experience levels and specialties took part in a two round Delphi survey which was conducted between March and July 2013. Each panelist was asked to rate each proposed criterion on a 1-9 Likert scale in order to show their level of agreement (i.e. 1 reflects strong disagreement and 9 reflects strong agreement).
Main Outcome Measure:
Development of a consensus-base list for safety practices in pediatrics.
Results:
Twenty-two of the 24 professionals invited to take part in this survey (92% participation rate) completed the two Delphi rounds. At the end of the two Delphi rounds, a total of 38/48 (79%) safety practice compliance criteria achieved consensus by the panelists. The criteria were grouped into 23 domains.
Conclusion:
This study presents the development of a self-assessment tool for safety practices in the pediatric drug-use process using a Delphi method. This tool may be used in order to record and compare the prevalence of best safety practices in the pediatric drug-use process.
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